(1). Field of the Invention
This invention relates, in general, to pillows and cushions or head supports and, more particularly to a compressible means for supporting one's head and neck during an operation. Even more specifically, the invention relates to an orthopedic support means whereby a patient's forehead and chin may be supported when the patient is lying in a prone position, i.e., face down on the stomach.
(2). Description of the Prior Art
There are three basic reclining positions, namely, prone, supine, and hemiside. when lying down, e.g. to go to sleep, a person may choose to lie in one position or the other. Actually, while sleeping, however, a person may sometimes intentionally, or other times unconsciously, change from one position to the other.
Many persons prefer, when going to sleep, to lie in the prone position, i.e., face down on their stomach. A major problem with lying in such a position, however, is that in order to breathe properly the neck must be turned at an acute angle of almost 90 degrees. This somewhat awkward positioning of the neck invariably causes increased pressure on the structures that support and comprise the neck anatomy. These include the discs, the joints, the ligaments and the muscles of the neck. Also, as a result of the neck being so turned, the cervical nerves can be irritated causing pain.
Thus, it is not uncommon for persons that sleep in the prone position to have cervical muscle sprain, ligament sprain and cervical nerve injury as a result of symptoms related to lying in that position with the neck rotated acutely. In some cases, at least, the problems can become quite severe, necessitating orthopedic surgery.
In certain surgery also, it is necessary for the patient to lie on the operating table in the prone position. There is no choice. This may even be for operation on, e.g., a herniated cervical disc. And such may have resulted from that patient having slept in the prone position and unduly twisting his neck as earlier disclosed. Obviously, such a patient cannot have his neck twisted for performing such an operation. The patient's head in such an operation must be supported in an upright position in a suitable manner. This necessitates, however, whatever the manner of support, that the patient be made comfortable and, of critical concern, that his breathing be unobstructed. It is also important that such a patient's head be supported during the operation in such a manner that his spine is maintained in a linear anatomic position.
Of further, and critical, importance also is the fact that during an operation wherein the patient is lying in the prone position, it is necessary that the anesthetist or anesthesiologist be able to view the patient's face and facial features during the administration of anesthetics. Furthermore, there is need for there to be provided one or more openings in the head support for use by the anesthetist, for endotracheal air tubes, nasogastric tubes, etc., commonly used during surgical operations.
Heretofore, others have been somewhat active in making inventions suitable for use in the support of a patient's head in various types of surgical operating procedures. Exemplary of such prior art head supports of which I am aware are those disclosed in U.S. Pat. Nos. 3,694,831; 4,074,376; 4,710,991; 4,752,064; and 4,757,983.
U.S. Pat. No. 3,694,831, which issued on Oct. 3, 1972, discloses a so-called "medical head support" which, in general, comprises a body including a base portion and an upper portion, each of a porous, open cell polyurethane foam. The base portion is of a cubic shape with a hole extending vertically downwardly therein from the top to the bottom surface. The upper portion comprises two spaced-apart pads each having a top planar-surface which slopes inwardly and downwardly. Thus, there is provided an elongated groove. This groove is provided with opposed arcuate-shaped notches at a location above the top opening of the hole in the base member. The patient's head is thus supported by the spaced-apart pads, the groove and arcuate notches providing an open space into which the patient's nose and face may intrude. According to the patentee there is no danger of the patient's breathing becoming blocked since the coarse foam of the base portion will allow free flow of air through the base portion into the cylindrical-shaped opening provided in the base. Furthermore, it is disclosed that a free flow of air is allowed into the groove from the coarse foam of the pads.
The medical head support disclosed in U.S. Pat. No. 3,694,831 is, to my knowledge, the only such device as disclosed in the above mentioned patents presently being used for its intended purposes. Nevertheless, the use of this head support is attendant with certain disadvantages. It does not offer full support to a patient's forehead. And, it offers no support at all to a patient's chin. Thus, as a result, the patient's cheek bones are primarily the means by which a patient's head is supported by the head support disclosed. This results in pressure points at the cheek bones which during a long operation can result in extreme soreness. Moreover, the manufacture of the head support disclosed in U.S. Pat. No. 3,694,831 is bound to be somewhat costly. This is due, at least in part, to the fact that a number of separate components are formed separately and then assembled together.
The invention disclosed in U.S. Pat. No. 4,074,376 is a contoured security pillow which, according to the patentee, is for supporting a person's head in the hemiside reclining position. Although this pillow may be found quite satisfactory for its intended purpose, such would not be suitable at all because of its structure for supporting a patient's head in the prone position.
U.S. Pat. No. 4,710,991 discloses a headrest pillow for use in combination with the headrest provided on a conventional therapeutic table. Such a table, as disclosed in U.S. Pat. No. 4,710,991, comprises two spaced-apart elongated support pads typically being made of felt, foam rubber or polyurethane foam and covered by an outer covering of leather or suitable synthetic plastic material. The spaced-apart pads define an elongated trough or groove into which a person's nose and mouth intrude when such a patient is in the prone position. According to the patentees, the pads in supporting a patient's head have been found not to distribute the weight evenly and, accordingly, not only discomfort but pressure necrosis may result.
Thus, the invention in 4,710,991 provides a pillow for use in combination with a headrest such as is disclosed. The headrest pillow comprises a plurality of layers of plastic film sealed together in such a manner that individual chambers are provided for inclusion of a suitable viscous gel. Such a pillow is suitably fastened to each of the head support pads allowing for more even, according to the patentees, distribution of support and weight forces between the headrest and patient's head thereby making the conventional headrest more comfortable to the user.
Although such a headrest pillow as disclosed in U.S. Pat. No. 4,710,991 may be found quite suitable for use as disclosed, it does not appear that such a pillow could be used at all without other support means, e.g. the headrest disclosed in U.S. Pat. No. 4,710,991, in combination therewith, in an operation wherein the patient is in the prone position. It seems also that although the headrest pillow may better distribute the weight of the patient's head, as claimed by the patentees, the same problem to be solved still exists. The patient's head is still supported by the cheekbones.
Furthermore, the manufacture of the headrest pillow in U.S. Pat. No. 4,710,991 is believed likely to be somewhat costly. It involves not only the lamination of a plurality of plastic films together, during which a plurality of individual chambers are formed, but also the inclusion of a viscous gel in each such a chamber. Moreover, it seems likely that one or more of the gel filled pockets may tend to leak, through repeated handling of the headrest pillow. This is particularly a possibility, if such pillows are capable of being sterilized again and again for repeated usage.
U.S. Pat. No. 4,752,064 discloses a therapeutic head support of resilient closed cell medical foam, according to the patentee, for supporting a patient's head face down during an operation. The device is comprised of a cubic-shaped pillow having a T-shaped void provided therein which extends from the top surface through to the bottom surface. This T-shaped void, according to the patentee, conforms to the contours of a patient's face. According to the disclosure in U.S. Pat. No. 4,752,064, the shape of the void provides total support for the head but does not interfere with the critical facial areas of the mouth, nose, and eyes.
Nevertheless, it is believed that a critical disadvantage results in the use of such a head support, as disclosed in U.S. Pat. No. 4,752,064. This resides in the fact that in order for the surgeon to be able to communicate with the patient during an operation a special support system for the pillow must be used. Thus, the pillow is located off the operating table, supported by a horizontally disposed plate having a corresponding T-shaped opening provided therein. An adjustable mirror is located below the plate so that the patient's face can be seen by the physician and communication can be maintained, if desired. The requirement for such a support system with the invention disclosed is deemed, moreover, a necessity for a surgical operation on a patient in the prone position. otherwise, there is no way in which the patient's face can be observed by the anesthetist. As can be readily appreciated, the cost for such a therapeutic head support as disclosed in U.S. Pat. No. 4,752,064, at least initially, will be increased considerably due to the necessity of having to also purchase a support system, even though it can be used repeatedly later with any number of the same construction therapeutic head supports.
U.S. Pat. No. 4,757,983 discloses a head and chin rest for face-down operations. The head and chin rest comprises, in general, a frame including spaced-apart cushioned forehead and chin supports. The chin and forehead supports can be on the same level or one above the other, as desired. Although, the various prototypes of the invention disclosed in U.S. Pat. No. 4,757,983 may provide good results in use in that each allows ready and convenient access to the prone patient's face, in particular the nose and mouth, by the anesthesiologist, the fact remains that such supports are relatively complex in structure. Furthermore, it is believed that such head and chin rests are likely to be somewhat costly to manufacture.
Thus, there still remains a need for a means of relatively simple construction to properly support a person's head when lying in the prone position during a surgical operation. Such a means need allow freedom for unobstructed breathing and easy access to the person's nose and mouth by an anesthetist. Moreover, such a head rest need be capable of being economically manufactured.